From the Guidelines
The recommended dose of dexamethasone for children via injection is 0.02 mg/kg, with a minimum single dose of 0.1 mg and a maximum single dose of 0.5 mg for a child and 1.0 mg for an adolescent, as stated in the study published in Pediatrics in 2008 1.
Key Considerations
- The dose may be repeated every 5 minutes to a maximum total dose of 1 mg for a child and 2 mg for an adolescent or adult.
- For intramuscular (IM) administration, the dose is 0.02–0.04 mg/kg.
- It is essential to note that dosing should be individualized based on the child's weight, age, medical condition being treated, and severity of illness.
Administration Routes and Dosing
- IV/IO: 0.02 mg/kg, with a minimum single dose of 0.1 mg and a maximum single dose of 0.5 mg for a child and 1.0 mg for an adolescent.
- IM: 0.02–0.04 mg/kg.
- ET: Neonates: 0.01–0.03 mg/kg, children and adolescents: 0.03–0.06 mg/kg.
Important Safety Information
- Incorrect dosing of dexamethasone can lead to serious side effects, including immune suppression, growth issues, and hormonal imbalances.
- Administration should be under direct medical supervision, and parents should never attempt to determine dosing without medical guidance.
- The medication is a potent corticosteroid used for various conditions, including inflammation, allergic reactions, certain cancers, and cerebral edema, among others.
From the Research
Dexamethasone Dosing for Children via Injection
- The dose of dexamethasone for children via injection can vary depending on the condition being treated and the age of the child 2, 3, 4, 5, 6.
- For the prevention of post-extubation stridor, exposure-matched predictions of dexamethasone PK indicated that doses (in mg/kg) for the 2-6 year olds can be applied in 3 month-2 year old children, whereas lower doses are needed in children of other age groups (60% lower for 0-2 weeks, 40% lower for 2-4 weeks, 20% lower for 1-3 months, 20% lower for 6-12 year olds, 40% lower for 12-18 years olds) 2.
- For children with obesity, single and multiple IV dose(s) of 0.5 and 1 mg/kg every 8 h resulted in 68% or more of virtual children with obesity attaining simulated exposures that were within exposure ranges previously reported in adult studies 3.
- For the treatment of croup, a dose of 0.15 mg/kg of dexamethasone may be as effective as the standard dose of 0.60 mg/kg 4.
- For acute asthma exacerbations, 2 doses of dexamethasone (0.6 mg/kg/dose) may be an effective alternative to a 5-day course of prednisone/prednisolone 5.
- A single dose of IM dexamethasone (0.6 mg/kg, maximum 15 mg) showed no clinically meaningful difference in outcomes compared with a 5-day course of oral prednisolone for the treatment of moderate acute asthma exacerbations in young children 6.